“In spine surgery, less is generally more. I tailor my approach to each patient’s symptoms and goals, using the least invasive means to achieve the fastest and most reliable recovery possible.”
Dr. Peter Derman, a minimally invasive and endoscopic spine surgeon at the Texas Back Institute, graduated with honors from Stanford University, where he majored in Biological Sciences. He received his medical degree from the Perelman School of Medicine at the University of Pennsylvania and concurrently obtained a Master of Business Administration from the Wharton School of Business. Dr. Derman completed his residency at the Hospital for Special Surgery in New York City and underwent further fellowship training in spine surgery at Rush University Medical Center in Chicago, Illinois. Beyond helping patients, Dr. Derman conducts medical research to better medicine for future generations.
Call 972-618-5000 to schedule an appointment with Dr. Derman.
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Im sorry dr if you think all annulsr tears heal on their own well your young,,mine went on for 3 years and a discogram confirmed 2 levels,,i had the endoscopic disc vleanout and got my life back,,these need to be fixed if not healed ,my life was destroyed
Congratulations 🎊
Congratulations Dr Derman
congratulations 👏🎉
Congratulations Dr Derman. 🎉
Congrats doctor!
Congratulations 🎊
Congratulations Dr Derman!
Thank you! 😊
Sir what if petient facing urine sensation loss and also half erectile dysfunction, sciatica...mri shows mild compression..do you think petient needs surgery?? He is only 21 india
Hello doc, I have severe spinal stenosis and normally by shots it feels better. I want to know how long do I continue to take the shots and Medication before I have to do surgery? Please help me doctor
I’m sorry to hear that you are struggling. Surgery may be considered if other modalities (e.g., non-narcotic medications, PT, and injections) fail to provide substantial relief of sufficient duration. In most cases, it is a quality of life determination that is ultimately up to the patient to decide.
Great work. Have you seen the Dr deuk laser spine surgery video's? And thoughts please 🙏 thanks
Doc please help me. I need your advise. My current situation cervical spine radiculopathy. Both arms has tingling feeling. Surgery it not my option coz i cant afford it. Maybe your advise could help me, please🙏
I’m sorry to hear that you’re struggling. Consultation with a spine specialist certainly seems like a good next step. Hang in there!
Thank you for describing. As fast as you did, so far the others I've viewed either have no voice or text; one is so outta focus it's not helpful at all
an artist 👍
Do you or someone at Texas Spine have experience with cauda equina, please.
Cauda equina syndrome, if present, is a true spine surgical emergency. Common symptoms include severe back and leg pain coupled with genital numbness and bladder / bowel dysfunction. Patients experiencing these should be evaluated in the emergency department immediately.
@@peterdermanmd Thank you so much for responding. Me 71 female have all the symptoms I'm in Waco, Tx no doctor here will even talk with me, just had epidural did not work, bowel problems for several years, past couple of years left hip pain and pain down left leg to knee left big toe goes numb. Very limited income somewhat hard to travel. But I'll find a way. Do you take United Health Care Dual Complete. Had to push my primary to get an MRI and wow all that is wrong. Doing all my own research discovered Clauda equina much info from places in Europe but nothing on youtube here in US. You mentioned it in your video from seattle. PLEASE tell me all the info you need. Can I send you like I've seen on other videos copy of MRI and what other xrays would you need. Am going to push on my primary Dr Benjamin Perry to help me get you info for evaluation. Even if I don't have CES my pain is becoming to much and to debilitating to live this way I know I still need surgery. Blessing
Hi Doctor, I need a endoscopic discectomy L5S1. I’m trying to call your office.
Sorry to hear you’re suffering. My office number is 972-608-5000 and the email is [email protected]. If you reach out, my staff will be able to assist.
I am so glad I took the trip to see you. I have not been able to stand straight up for years, and now walking is no longer painful for me. I now very much look forward to my retirement time with my family. We have a lot of vacations in the planning stages now. God Bless you Dr. Derman, and thank you.
I’m so thrilled that you’re feeling better! 😊
Can Turmeric be that great, if it is 99% of Indians must be healthy...But reality is different..
The amount of tumeric necessary for anti-inflammatory benefit is more than is obtained via dietary consumption. You have to take 1,000 mg per day with peperidine. Also, it’s not a magic substance that cures all ailments… but it does have natural anti-inflammatory effects that can be helpful for pain.
Beautiful surgery. Congratulations even better with your daughter. ❤
Call me crazy but I prefer low intensity cardio like walking or even riding a bike.
Just because running doesn’t appear to harm the spine doesn’t mean it will be comfortable for everyone. Low impact cardio can be a good alternative. The key is finding what works for you.
This is my exact problem I have been fighting it for years. multiple epidural injections but little success. Going see you on 01/26/24 from south west Louisiana
Sorry you’re struggling. Looking forward to meeting you and developing a plan to help you feel better. Hang in there!
Im looking for Dr. Noah!! He sounds like a good guy! Smart too. I bet he loves chocolate milk!! Thanks for this video. Im in search of a spine center just now. I have issues with L3-4-5. Text book symptoms. But it could be 8 different things.
Haha! Noah never ceases to amaze me. I’m so proud of my little guy. And yes, he does like chocolate milk! 😂 Sorry to hear you’re struggling. If you can’t wait 27 years for Noah to finish his medical training, we’d be happy to help you sooner at Texas Back Institute if you don’t mind settling for me instead. Feel free to call 972-608-5000 to discuss setting up a consultation.
Here’s my MRI. Can you tell me your opinion on performing this surgery for my condition? Thanks C3/C4 left asymmetric disc bulge causing mild spinal canal stenosis No nueroforinaminal stenosis C4/C5 Left asymmetric disc bulge causing moderate to severe spinal canal stenosis and moderate / severe right nueroforinaminal stenosis C5/C6 left asymmetric disc bulge causing moderate / severe spinal canal stenosis / Severe left/ moderate to severe right nueroforinamonal stenosis C6/C7 Symmetric disc bulge causing mild spinal canal stenosis no nueroforinaminal stenosis I have full range of motion. I just get on and off numbness in my left arm and weakness. I just need to take pressure off that nerve from disc bulge. What surgery would you consider? What success rate do I have based on my MRI? What are chances it could reherniation if I take care of it properly? Thanks great work on your vids. It looks amazing.
Sorry to hear that you’re suffering. I’m glad you’ve found my videos informative. Unfortunately, I am unable to make assessments based on an MRI report alone. However, I’d be happy to review the actual images and perhaps set up a visit where I could assess further and develop a plan to help you feel better. If you call (972-608-5000) or email ([email protected]) my office, the staff can help coordinate. Hang in there!
@@peterdermanmdthanks for reply. I’m actually in CA. Not sure if you can recommend anyone in LA area who does what you do? You seem like you have really good skill at this procedure. I’ll give you a call. Id be willing to travel.
@@groovefretboard… unfortunately I’m not aware of anyone in your area who is doing cervical endoscopic spine surgery. I’m looking forward to evaluating your case further and providing some direction. Kudos to you for doing your research!
So traction and TENS are not recommended? I’m using this every PT session
Correct. There was not sufficient evidence to support the effectiveness of these interventions. If you’re curious to read the full report, it can be found here: www.who.int/publications/i/item/9789240081789
This is interesting because I was told there's no bone removal in endoscopic surgeries at least in the lumbar spine for removing oestephytes and disc herniations. Can you please confirm this|?
The anatomy of the lumbar spine is different than that of the cervical spine. In this lumbar spine, there are openings between the bones (eg, interlaminar window and foramena) that are often large enough to allow access into the spinal canal without removing any bone. This is not the case in the cervical spine. However, a small amount of bone can be removed without adversely impacting the stability of the spine.
ok Doc. thanks for replying. I really like your postive attitude and the way you explain things. Someone once told me Koreans are masters of endoscopic approach. I'd like to know how does an endoscopic PCF differ to a normal cervical disectomy/foramintomy/lami(otomynectomy/? Are you able to make a video on this in terms of bone removal etc? Also what are your thoughts on gel based anti adhesion barriers? Do you use them? @@peterdermanmd
@@varuninnz… Great questions. The endoscope allows me to perform a posterior cervical foraminotomy / discectomy without the soft tissue disruption (and resultant degree of post-operative neck pain) inherent to traditional and even tubular approaches. While some bone removal is necessary, this is less than with other approaches because of the off-angled optics of the endoscope and the ability to undercut the undersurface of the facet. BTW… I don’t find that any sort of anti-adhesive barrier is necessary, and these are inherently small spaces so anything added can take up space, press on the nerve, and potentially cause issues. Feel free to check out some of my other videos for additional information: kzread.info/dash/bejne/iYOOxbidkavFhNo.htmlsi=vsqbUc_XQ_ySjP0g kzread.info/dash/bejne/amVky7WBidG9eMo.htmlsi=OcY4KeQ6QeQUob-z
Going from the front of the neck to do remove a broad posterior herniation can be extremly difficult from an anterior approach and not every surgeon can do it because the access is so limited esepcailly if it's calcified into an oesteophyte. It is for this reason I advise a lot of patients to avoid aritifical disc replacement if they have a super broad herination and start off with an endoscopic PCF. You can always get ADR after. Very nice video doc and love your son Noah, Merry christmas and Happy Holidays.
Thanks for watching! I prefer an endoscopic posterior cervical foraminotomy for anyone with symptomatic stenosis (due to disc herniation and/or bone spurs) isolated to the foramenal region. Cervical disc replacement (which I also perform) can be a good option for patients who don’t meet these criteria.
Looks more difficult than the previous one!
Endoscopic cervical surgery is indeed a more advanced technique. Among other things, surgery is performed in close proximity to the cervical spinal cord (which is a more sensitive structure than the lumbar nerve roots). However, it is an excellent ultra-minimally invasive, motion preserving solution in the hands of an experienced spinal endoscopist.
You don’t use hardware?
No… the beauty of this procedure is that it allows surgeons to take pressure off of nerves without the need for implants. Motion is preserved, and there is minimal surgical pain given the ultra-minimally invasive endoscopic approach.
wonderful demonstration.
Hello Dr. I have a painful annular tear at L5-S1 level. No herniation of the disk or radicular pain - just axial back pain. Are you able to remove loose disc fragments within an annular tear? I'm in Dallas too. thank you!
Hi there. I’m sorry you’re struggling. Symptomatic annular tears tend to heal with time without surgery. I typically recommend an initial course of conservative care (PT, non-narcotic medications, time, and occasionally epidural steroid injections). Patients with persistent symptoms despite this likely have pain due to the underlying disc degeneration rather than the tear itself. So a lumbar disc replacement (rather than an endoscopic decompression) might be an option if all else fails.
hi Dr. Derman. I mailed my mri images to Plano. Wondering if you get a chance to review it and my case can be treated by endoscopic spine surgery. Thanks in advance.
You are a great father. Great surgeon too.
I had the exact same surgery 4 months ago and since then I have pain in my feet only when I sit I went to a lot of doctors they couldn’t figure out what’s going on with me and when I asked my surgeon he said the nerve needs 6 months to a year to heal but the problem I had the same pain even before my surgery in my feet only and when I sit only please doctor do you have any clue on what’s going on with me please 🙏 the pain only when I sit and thank you
I’m sorry to hear that. A pinched nerve in the neck causes symptoms in the arm. It would not be expected to create foot symptoms. I therefore wouldn’t expect a cervical foraminotomy to alleviate foot symptoms, which might be coming from a low back issue, a peripheral nerve issue, or a foot issue. Best of luck… hang in there!
@@peterdermanmd I had a microdistactomy L5s1 and same pain only on my feet before and after the surgery am sorry I didn’t see the title of the video?
Hello Doctor Peter, I got a big discount herination and need a surgery as soon as possible. I am willing to fly to Texas and have surgery with you. I am wondering if you can offer online appointment for me to review my MRI(11/07) and get a surgery scheduled. Thanks
Disc herination. I like your videos and impressed by your passion and technique on minimally invasive surgery.
Hi there. I’m sorry to hear you are struggling. If you call my office at 972-608-5000 or email at [email protected], my staff can help facilitate. Hang in there!
Sir you accept foreign patients i am from bangladesh and suffering l4 l5 disc bulge
Sorry to hear you’re suffering. As much as I’d enjoy visiting Bangladesh, you’d have to come here to the United States for treatment with me. Hang in there!
@@peterdermanmd can you give me a medical Visa
Feel free to reach out to our Chief Development Officer, Cheryl Zapata ([email protected]), to inquire.
@@peterdermanmd thank you
You wouldn’t be willing to travel to Connecticut by chance would you? I just watched your video on l5 herniation. I been dealing with it for 3 years and been through all of the steps but can’t seem to find someone I trust. After hearing you with your son reminds me of my kid lol. I just want to get pain free and enjoy life again but want the right doctor. Feel free to reach out
Haha… I can’t come operate in Connecticut, but many patients make a brief trip to Dallas for this ultra-minimally invasive procedure! Feel free to call 972-608-5000 to arrange a consultation with me if you’d like to learn more.
Hello Dr.. A question if I may. When a patient walks into your office with an MRI report and disk. Complains of tingling under both feet. Some tingling up the left calf. No loss of strength. Has balance. Can walk on his heels. Has pain in the upper glutes. And pain in the lower part of the spine. The image and report shows herniation L4 L5. S1 bulge. After reviewing the image and report, what is your next step with the patient who is sitting in your office . How do you measure whether the patient needs surgery and if so what type of surgery
Hey Doctor, love your videos and demeanor. Can you get an endoscopic discectomy without jeopardizing spondylolisthesis stability. It seems that a regular microdiscectomy will increase my chances greatly of needing fusion later.
Good question. In many cases, an endoscopic discectomy can be performed without the removal of any bone and with minimal disruption of the soft tissues. As such, there are many cases in which I’m comfortable performing such procedures in patients with spondylolisthesis. 👌
Can you do cervival adr after a posterior cervical formantomy
Yes indeed. That’s part of the beauty of this ultra-minimally invasive procedure… it is extremely effective in approximately selected patients and doesn’t burn any bridges in the event that something else is needed down the line. I’ve even done it in patients who came to me with a previous cervical disc replacement but with residual foraminal stenosis. 👌
@peterdermanmd oh because I had 2 level posterior formantomy endoscopic 16 yrs ago at bonati spine. At c34 and c56. Unfortunately surgeons in nyc told me c56 to much facet taken and need fuse c56 possible hybrid adr c34 and fuse c56. But only few doctors most said after any posterior fuse only option
@@thelenny38… I am very careful not to remove more than 50% of the facet joint with a posterior foraminotomy. This is enough to provide relief without eliminating disc replacement as an option. If the surgeon who operated on you removed too much of your joint, unfortunately disc replacement might not be an option.
Hey doc love your videos.
I’m glad you enjoy them!
@@peterdermanmd happy my back pain journey brought me to your office
1,5 year after l3 l5 lumbar fusion, x ray ok, can i jump rope??
That’s something that you’ll need to discuss with your surgeon. But I don’t put any long term restrictions on my patients after surgery. The body is smart and tells us if we are causing damage or irritation. Exercise is good for physical, mental, and spine health. I tell my patients, “If it hurts, don’t do it; but if it doesn’t, go for it.”
Can you please make a video similar to the lumbar spine one with your 5 year old in the background?
Thanks for the suggestion. Here you go: Endoscopic Spine Surgery - Start to Finish Posterior Cervical Foraminotomy with Dr. Derman and Son kzread.info/dash/bejne/dYp7z9qFdqbKm9I.html
Hi Dr. Derman, can this surgery be done at multiple levels and on both sides (bilaterally) without making the spine unstable?
Great question. Posterior cervical foraminotomies could theoretically be performed on both sides and at multiple levels without causing instability. However, I find that a careful workup often allows me to narrow symptoms down to a single symptomatic site, which means even less surgery for my patients. 👌
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Thank you so much Dr. Derman for helping to get my health and life back!!! Everyone this doctor is amazing!! I had been suffering in pain for 2 1/2 years from lower disc being put of place. And there is no way that I could have rode a bike prior to the surgery! The outcome of the surgery superseded my expectation’s! And I was amazed at the care, knowledge and the patient centeredness that i received. Everything was so on point! I’m now back to my full activities walking jogging exercising I rode a bike not too long ago above all I have no more pain. The pain was gone day one of the surgery. Again thank you Dr. Derman you are amazing, you and your team if I had to do it over again GOD forbid, but i would definitely reach out to you and your team!!!! You gave me back a quality of life and I am so thankful!
I’m so glad you’re back to feeling good and living your best life… pain free!
@@peterdermanmd Thank you! I’m so much happier now and totally pain free. You are the best! One the world should know about! Blessings!
Very impressive, but..... what if you have a Level 1 Spondy and most doctors want to do a fusion as well as a laminectomy? Most docs want to do the fusion which could lead to other fusions in a few years, yet if you just do the laminectomy, this could lead to further slippage of the Spondy! Very confusing to the patient and as we say in Texas, Damn if you do and damn if you don't".!
You bring up a very good point regarding a common scenario. My goal is to avoid fusion if at all possible. The traditional teaching is that a laminectomy destabilizes a spondylolisthesis so fusion is necessary in addition to decompression. However, we have good evidence that a minimally invasive, midline-sparing laminectomy does not destabilize the spine and can be performed in many cases in the absence of fusion. I frequently perform such minimally invasive laminectomies in the setting of a stable grade 1 spondylolisthesis with excellent results. This addresses nerve compression without exposing patients to fusion and the associated issues of accelerated degeneration at the adjacent levels.
@@peterdermanmd thank you Doctor. I will be setting up an appointment with you soon.